Robotic Radical Nephrectomy Becoming More Common
And robotic laparoscopy for rectal cancer resection does not reduce risk for conversion to open surgery
WEDNESDAY, Oct. 25, 2017 (HealthDay News) -- From 2003 to 2015 there was an increase in use of robotic-assisted radical nephrectomy, according to a study published online Oct. 24 in the Journal of the American Medical Association. In a separate study, researchers found that robotic-assisted laparoscopic surgery for resection of rectal adenocarcinoma does not significantly reduce the risk of conversion to open surgery when compared with conventional laparoscopy.
In Gab Jeong, M.D., Ph.D., from Stanford University Medical Center in California, and colleagues assessed outcomes for patients who underwent robotic-assisted or laparoscopic radical nephrectomy for renal mass at 416 U.S. hospitals. Data were included for 23,753 patients, of whom 18,573 underwent laparoscopic radical nephrectomy and 5,180 underwent robotic-assisted radical nephrectomy. There was an increase in use of robotic-assisted surgery from 1.5 percent in 2003 to 27 percent in 2015. No significant between-group differences were seen in the incidence of any postoperative complications. In the adjusted analysis, patients undergoing robotic-assisted procedures had a higher rate of prolonged operating time than patients receiving the laparoscopic procedure.
David Jayne, M.D., from St. James's University Hospital in the United Kingdom, and colleagues compared randomized 471 patients with rectal adenocarcinoma to resection with robotic-assisted or conventional laparoscopic surgery. Of the 466 patients who completed the study, the overall rate of conversion to open laparotomy was 10.1 percent, and the overall circumferential resection margin positivity was 5.7 percent. There were no statistically significant between-group differences in any of eight other prespecified secondary end points.
"These findings suggest that robotic-assisted laparoscopic surgery, when performed by surgeons with varying experience with robotic surgery, does not confer an advantage in rectal cancer resection," Jayne and colleagues write.
Authors in both studies disclosed ties to Intuitive Surgical Inc.